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[A preprosthetic-surgical solution for the extremely atrophic mandible].

Failures of reconstructing alveoloplasty, which are known from the literature and confirmed by the author's personal experience, are attributed to the intolerance of the load-carrying denture support. For this reason, it is suggested to perform an extra-oral intervention on the maximally atrophied mandible to reinforce its crest with autogenous bone. A second intervention is necessary in the form of a combination of floor-of-the-mouth revision and vestibuloplasty (method of Rehrmann), the load-carrying support remaining intact at the level fo the alveolar process.

Alveoloplasty↗

[New criteria for the characterization of facies leprosa].

Facies leprosa was characterized by a combination of nasal change and resorption of nasal bone, anterior nasal spine, supra-incisive alveolar region and anterior alveolar process of the maxilae, associated with the loss of upper incisors teeth, according to the criteria of radiographic interpretation.

Bone Resorption↗

[Pre-prosthetic plastics of labial vestibule in patients with toothless lower jaws].

The acquired practical experience in the treatment of 20 in-patients is shared. All of them had advanced and severe atrophy of alveolar process and the body of mandibule. Two methods of vestibuloplastics were mainly applied: according to K. Schuchardt and the method of H. Pichler. The very good early and late results attained as regards the prosthetic field enabled the accomplishment of functionally fit prosthetic construction.

Adult↗

Dental development and the pharyngeal lymphoid tissue.

Because the teeth are housed and develop within the jaws, skeletal development of the maxilla and mandible is a primary factor in the consideration of any problems pertaining to the developing dentition. Growth of the posterior nasal choanae, the maxilla, and the nasopharynx should be evaluated as a unit in assessing the favorable or unfavorable character of the nasopharyngeal region. Both large and small adenoidal tissues should be examined in light of the morphologic character of the nasopharynx (be it small, large, narrow, or wide) and related to the developing maxilla. Variables in size and location of the maxilla and the pharynx will play an important role in the impact that lymphoid tissue will have on the patency of the nasopharyngeal isthmus. Synchronized growth between the normally developing adenoids and the migration of the maxilla away from the cranial base will produce a balanced environment that precludes nasal obstruction by the presence of adenoids. With time, the changes in spatial relationships between the posterior border of the maxilla and the posterior pharyngeal wall plus atrophy of the adenoidal tissue will generally minimize or eliminate the problems of nasal obstruction and mouth breathing. Growth data may be used to evaluate the status, assess progress, measure comparability, determine inheritance patterns, and confer individuality. Unit-trait inheritance of the teeth, alveolar processes, maxilla, mandible, soft-tissue profile, tongue, pharynx, and lymphoid tissues may well produce more definitive answers to the question of the developing dentition and the pharyngeal lymphoid tissue. Finally, at present, no clinician can categorically state that enlarged tonsils or adenoids per se are responsible for abnormal dentition in the absence of other factors.

Adenoids↗

[The upper buccal vestibule in clefts].

The buccal vestibule is described and its physiologic interest with respect to the position of alveolar processes emphasized, the latter being compromised by the cleft and its repair. The need for its restitution to ensure function of good quality implies the use of a total skin graft before school age for cases of total bilateral clefts.

Child, Preschool↗

[Long-term results of glossectomies].

Analysis of results of a series of marginal glossectomies, performed for orthodontic or orthopedic indications over the last 10 years, showed sustained improvement of alveolar process inclination with practically inexistant functional or psychologic sequelae.

Adolescent↗

Geronto-anatomical aspects of the buccinator muscle in prosthetic stomatology.

Alongside with the absorption of the alveolar process in advanced age, fibers of the buccinator muscle cease to originate there. In consequence, the course of muscle fibers in the lower portion of the buccinator is virtually parallel to the mandible in toothless individuals. Smoothness of the accessory mandibular recess, as well as the favourable structure of soft tissues render this region an important bearer for the dental plate. Rearranged origin and course of the buccinator muscle in toothless individuals allow for an extension of the denture and contribute to the ventil-like closure of the plate.

Aged↗

Warty dyskeratoma.

A case is reported of a 53-year-old woman, who had had for one year a wart-like papillomatus lesion on the alveolar process in the region corresponding to m The remaining mucosa exhibited a normal clinical picture. The patient's general health was satisfactory and no skin manifestations of interest were apparent. The lesion was extirpated and examined histologically and microradiographically and was found to have histopathological characteristic of the same kind as in warty dyskeratoma. The discussion is concerned with aetiological factors and with problems of differential diagnosis.

Female↗

Metrical analysis of growth changes in the jaws and teeth of normal, protein deficient and calorie deficient pigs.

Weanling pigs were separated into three groups: control animals were allowed unlimited food; protein deficient animals were allowed unlimited carbohydrate or fat but restricted in protein intake; calorie deficient animals were restricted in total food intake. The skulls and teeth of animals killed at one year and at two years of age were measured from radiographs, and from the results were derived the following conclusions: (1) Pigs fed on protein and on calorie deficient diets all showed considerable retardation of the growth of jaws and teeth, consistently more severe in the calorie deficient than in the protein deficient animals. (2) The shape of the mandible was altered by both types of malnutrition, the height of the ascending ramus being reduced to a greater extent than either its anteroposterior width or the length of the body of the mandible. The labial alveolar process became more proclined with increasingly severe malnutrition. (3) The upper and lower jaws were retarded to a similar extent in both groups of experimentally malnourished animals. (4) Retardation of tooth growth was less severe than that of jaw growth. (5) Contralateral asymmetry of molar crown size in the protein deficient animals was initally quite marked, but when the teeth were approaching their final size the asymmetry was no greater than in control animals.

Animals↗

A review of surgical procedures designed to increase the functional height of the resorbed alveolar ridge.

By raising the alveolar ridge, relatively or absolutely, in partially or totally edentulous patients, preprosthetic surgery makes possible an improvement in the bed for the denture. Raising the height of the ridge, relatively, by deepening the sulci surrounding the jaw, can be achieved by vestibuloplasty and grafts to the floor of the mouth. However, for these procedures it is essential that there still be sufficient bone (at least 20 mm in the mandible). Long term observations show that the main problem is a reduction in the vestibular depth initially obtained by surgery. The most durable results follow vestibuloplasties with free skin or mucosal grafts, the latter being preferred. If resorption or atrophy is far advanced the jaw bone has to be reconstructed, so that an absolute increase in the ridge height is the aim. This is secured by onlay grafting, preferably of autologous bone, or inlay grafting (sandwich technique: horizontal osteotomy with bone interposition). In the lower jaw there is also the possibility of 'displacement grafting' (visor osteotomy: vertical osteotomy and visor-like displacement) and grafting to the lower border in cases of extreme mandibular atrophy. In the long term onlay grafts show a high degree of resorption; in appropriate circumstances, the results of the other methods are encouraging. A feature common to all procedures is a greater or lesser functional disturbance of the mental nerve.

Alveolar Process↗

Differences in craniofacial morphology between complete and incomplete unilateral cleft lip and palate in adults.

Differences in craniofacial morphology between complete and incomplete unilateral cleft lip and palate were studied in adult males by roentgenocephalometry. Incomplete clefts did not have the widening of the nasal cavity, reduction of the upper face height, or reduced thickness of the upper lip found in complete clefts. The shortening of maxillary depth was half that noted in complete clefts. The mandibular deviations and interorbital widening did not differ. The same held true for the retroinclination of upper incisors and alveolar process and backward shift of the maxilla. These changes accounted for differences in sagittal maxillo-mandibular relations, facial profile, occlusion of incisors and total facial height between complete and incomplete clefts. Limitation of anterior growth rotation of the face was identical. The independence of mandibular variations on the extent of the cleft and on maxillary malformation suggests the possibility of an underlying primary impairment of growth of the lower jaw, at least in some cases.

Adult↗